You can hardly open a newspaper or switch on the telly these days without reading or hearing about changes to sickness benefits. There’s no doubt about it that reforming sickness benefits is at the forefront of the welfare reform agenda – but what do the changes mean in practice for people who are claiming sickness benefits or are not able to work? Roddy Samson from Granton Information Centre gives a brief update of the changes so far…
What is it?
Employment Support Allowance (ESA) is a welfare benefit which was introduced in October 2008. All new claimants who are unable to work due to illness or disability (including mental health problems) are placed on ESA. The intention is to support people to access appropriate work, with a greater emphasis on what claimants are able to do. ESA has replaced Incapacity Benefit (IB) and Income Support (IS) paid on the grounds of incapacity. The government plans to review everyone on IB for suitability for ESA by March 2014. The review process started in October 2010.
How are people assessed for ESA?
The ESA assessment process usually takes around 13 weeks, but can be longer. During this period the claimant will undergo:
- A work capability assessment (WCA)
- A work-focused interview
The ESA work capability assessment is carried out by a health care professional contracted by the Department for Work and Pensions at the local assessment centre in York Place. It is designed to assess whether the claimant is capable of work or capable of work related activity.
- If they are assessed as incapable of work-related activity they are placed in the ‘support group’ and receive ESA.
- If they are assessed as capable they are placed in the ‘work-related activity group’ and receive ESA. People in the ‘work-related activity group’ are expected to undertake work-related activity as a condition of continuing to receive the full amount of ESA.
The Work Capability Assessment
This assessment applies to most claimants and determines whether or not they remain on ESA.
For this test you are assessed on your ability to carry out 17 listed physical or ‘mental, cognitive and intellectual’ activities. Points are awarded on the basis of your limitations with respect to each activity. These points are totalled up and if the total reaches the threshold of 15, you are deemed to have limited capability for work and thus stay on ESA.
Within each type of activity there is a list of descriptors with associated scores ranging from 0 to 15. The descriptors describe related tasks of varying degrees of difficulty. You score when you are not able to perform the activity described. Though more than one descriptor may apply to you, you can only pick up one score from each type of activity; in each case whichever scores the highest.
If you score 15 in any one activity, you automatically pass the test. If your score is less than 15, it can be added to the scores you pick up from any of the other types of activity (in both the physical and the mental parts of the test). If your total score reaches 15, you pass the test.
The physical activities
The physical functions in the limited capability for work test are grouped into 10 different types of activity. These are:
- Mobilising unaided by another person with or without a walking stick, manual wheelchair or other aid if such aid can reasonably be used.
- Standing and sitting.
- Reaching.
- Picking up and moving or transferring by the use of the upper body and arms.
- Manual dexterity.
- Making self understood through speaking, writing, typing, or other means normally used, unaided by another person.
- Understanding communication by both verbal means (such as hearing or lip reading) and non-verbal means (such as reading 16 point print) using any aid it is reasonable to expect them to use, unaided by another person.
- Navigation and maintaining safety, using a guide dog or other aid if normally used.
- Absence or loss of control leading to extensive evacuation of the bowel and/or bladder, other than enuresis (bed-wetting) despite the presence of any aids or adaptations normally used.
- Consciousness during waking moments.
The assessment takes into account your abilities when using any aid or appliance you would normally use.
The mental, cognitive and intellectual activities
These functions in the limited capability for work test are grouped into sets of activities under the following 7 headings:
- Learning tasks.
- Awareness of everyday hazards (such as boiling water or sharp objects).
- Initiating and completing personal action (which means planning, organisation, problem solving, prioritising or switching tasks).
- Coping with change.
- Getting about.
- Coping with social engagement due to cognitive impairment or mental disorder.
- Appropriateness of behaviour with other people, due to cognitive impairment or mental disorder.
Appeals
If the claimant is assessed as capable of work then they do not qualify for ESA. They can appeal this decision. If they appeal they can continue to receive the basic allowance of ESA until a decision is made on their appeal by a tribunal. Recent government figures show that appeals against ESA decisions are more successful if you have an experienced representative.
- Between April 2010 and April 2011 114,000 ESA appeals were heard by independent tribunals in the U.K.
- Of these 38% were successful
- However when the person appealing had professional representation this figure rose to 67%.
It’s important to remember that if you get a decision about your benefits that you’re not happy with you should seek advice as soon as possible as strict time limits apply if you wish to challenge them. Granton Information Centre provides free, impartial advice, assistance and representation on all benefit and tax credit matters.
Drop in sessions (Granton Information Centre):
Monday & Wednesday: All HOUSING issues: 9.30 – 12.30
Tuesday & Thursday: BENEFITS & MONEY ADVICE issues: 9.30 – 12.30
Outreach:
Tuesday: 10.00 – 1.00 CREWE MEDICAL CENTRE
(Only for patients of Crewe Medical Centre)
Tuesday: 2.00 – 4.00 MUIRHOUSE MEDICAL GROUP
(Only for patients of Muirhouse Medial Group)
Home visits and appointments may be available on request.
Telephone/Fax: 0131 552 0458, 134 – 138 West Granton Road, Edinburgh, EH5 1PE
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